How Trichotillomania Works

Stress has many of us reaching for our hair.
Stress has many of us reaching for our hair.

Many idioms in the English language use human hair as a means of describing emotions and conditions. If you let your hair down, you're going to let loose and get crazy. If you're caught by the short hairs, you don't have a means of escape. If something has made your hair stand on end, then you're terribly frightened. And if you're frustrated or angry, you may vow to pull your own hair out.

For some people, that last one is more than an idiom. It's estimated that about 2 to 4 percent of the population has trichotillomania, or an uncontrollable urge to pull out one's own hair [source: Landau]. Those with trichotillomania usually pull primarily from the scalp, eyebrows and eyelashes, but they may also pull hairs from their legs, arms or pubic area.

The term trichotillomania was coined and the symptoms were described in 1889, but the condition only became formally recognized as a disorder in the late 1980s, when the Diagnostic and Statistical Manual of Mental Disorders classified it as an impulse control disorder. Because trichotillomania is a relatively new condition and has received very little mainstream press, many people may be unaware that their behaviors constitute an actual disorder.

Additionally, trichotilliomania manifests itself differently in each person. For some people, the condition may be very mild -- people might pull their hair unconsciously while they read, watch television or lie in bed. For others, the condition is all-consuming. These people may feel tension or stress that is only abated when they pull out hair; the relief may prove to be short-lived, however, as guilt over pulling out the hair only leads to stress that causes them to pull out more hair. Some may set aside times to ritualistically go over the hairs on their bodies and pull some out, while other say that they pull out certain hairs that feel different or bother them. Sometimes the pulling is characterized as a self-soothing mechanism for those who are extremely depressed and anxious, while sometimes it's something that seemingly happy, healthy people engage in for no apparent reason.

In other words, there's no one type of person that is at risk for trichotillomania; however, those with the condition do share some symptoms, which we'll investigate on the next page.